Barb is a 60yoa female referred by her physican to your phase II cardiac rehab program due to her CVD risk factor profile and a graded exercise test (GXT) that was positive for ST segment depression. A brief synopsis of Barb’s medical history, recent labs, and GXT are shown below.   Family History: mother had a CABG procedure at age 58; older sister also had a stent placed at age 60 Medications: spironolactone 50mg x 2 daily; amlodipine 100mg x 1 daily Tobacco Use: former smoker; quit 20 years ago   Height: 5′ 3”                Weight: 162lbs                      Waist Circumference: 36in Fasting Blood Glucose 110 mg/dL Urea nitrogen 10 mg/dL Creatinine 1.2 mg/dL Sodium 136 mmol/L Potassium 3.6 mmol/L Chloride 105 mmol/L Total Cholesterol 192 mg/dL Triglycerides 195 mg/dL HDL-C 44 mg/dL LDL 102 mg/dL Aspartate aminotransferase (AST) 35 U/L Alanin aminotransferase (ALT) 42 U/L HbA1C 45 mmol/mol   Graded Exercise Test: Resting HR: 80bpm            Supine BP: 138/80            Standing BP: 140/82 Time Speed (mph) Grade (%) HR BP RPE MET Symptoms (0-4 scale) ECG 1 1.7 10 89         .5mm horizontal ST dep. 2 1.7 10 92         .5mm horizontal ST dep. 3 1.7 10 109 154/84 14 4.7   .5mm horizontal ST dep. 4 2.5 12 123         1mm horizontal ST dep. 5 2.5 12 136         1mm horizontal ST dep. 6 2.5 12 152 182/84 19 7.0   1.5mm horizontal ST dep. 7 1.7 0 140         1mm horizontal ST dep. 8 1.7 0 136 166/84       .5mm horizontal ST dep. 9 1.7 0 132         .5mm horizontal ST dep. 10 1.7 0 134 152/84       .5mm horizontal ST dep. 11 Resting seated 115         .5mm horizontal ST dep. 12 Resting seated 107 136/82       NSR   Which of Barb’s medications may impact her heart rate response to exercise? (select all that apply)

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